PhD Scientific Days 2024

Budapest, 9-10 July 2024

Poster Session T - Cardiovascular Medicine and Research 3.

Evaluating Cardiovascular Health and Risk Factors in Cancer Survivors: A Study from a Large East London Cohort

Author(s)

Liliana Szabo1, Jackie Cooper2, Dorina-Gabriela Condurache2, Isabel Dostal2, Rohini Mathur2, Fiona M. Walter2, Mamas A. Mamas3, Stefan Neubauer4, Nicholas C. Harvey5, Charlotte H. Manisty6, Steffen E. Petersen2, John Robson2, Zahra Raisi-Estabragh2
1: Semmelweis University Heart and Vascular Center
2: Queen Mary University of London
3: University of Manchester
4: University of Oxford
5: University of Southampton
6: University College London

Text of the abstract

Introduction:
This study examines the cardiovascular risk profile and management of hypertension and statin use among cancer survivors in East London, highlighting the interplay between cancer survivorship and cardiovascular health in a diverse population, in response to rising cancer survival rates and the associated increase in cardiovascular disease risk.
Methods:
Health records from over 1.2 million patients in East London were analyzed to compare the cardiovascular profiles of cancer survivors, categorized into 20 types, with four age and sex-matched non-cancer individuals each. The study employed multivariable logistic regression to explore associations between past cancer and cardiovascular outcomes, and assessed variations in meeting guideline-directed risk factor control among cancer patients with hypertension and ischemic cardiovascular diseases compared to non-cancer comparators.
Results:
The study consisted of 18,839 cancer survivors and 75,356 matched controls (64±15 years, 43% male) showcasing significant ethnic diversity (cancer survivors: 48% White, 24% Black and 22% Asian) and socio-economic deprivation. Patients with past cancer had a higher prevalence of hypertension (45% vs. 42%), chronic kidney disease (CKD) (17% vs. 13%), and CVDs including venous thromboembolism (VTE) (6.5% vs. 4.8%), atrial fibrillation (AF) (9.2% vs. 7.1%), and heart failure (HF) (11.3% vs. 8.7%). Regression models fully adjusted for shared risk factors, demonstrated higher risk of a range of CVDs in patients with (any) past cancer, including hypertension (OR 1.12, 95% CI 1.08-1.16), diabetes (OR 1.09, 95% CI 1.05-1.13), CKD (OR 1.31, 95% CI 1.26-1.36), and VTE (OR 1.35, 95% CI 1.28-1.42). The CVD risk varied across cancer types (Figure 1). In subgroup analyses, control of blood pressure and cholesterol did not differ significantly across cancer survivors and matched controls with hypertension and ischaemic CVDs, respectively.
Conclusion:
This study highlights the increased risk of VRFs and CVDs among cancer survivors, with notable variances across cancer types. Alongside this, we found no significant difference in achieving guideline directed control of blood pressure and cholesterol in cancer survivors and matched controls. These findings suggest that in our sample, the heightened CVD risk in cancer survivors is unlikely explained by inadequate risk factor control.